Organization
CENTRUM MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIELA VANESSA VICTORERO (COO)
(305) 266-2929
Entity
Organization
Contact information
Practice address
1463 S MASON RD, KATY, TX 77450-4568
(305) 266-2929
(786) 558-0242
Mailing address
9250 NW 36TH ST STE 420, DORAL, FL 33178-2775
(305) 266-2929
(786) 558-0242
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/18/2021
Last updated
01/27/2022
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